It is well documented in the literature that myocardial revascularization during valve surgery increases the risk of early mortality and morbidity.

According to the most recent version of the European Guidelines, the possibility of myocardial revascularization via coronary artery bypass should be evaluated in patients with an indication for surgical treatment of heart valve disease but with coronary artery stenosis ≥ 50-70%.

In this study, patients hospitalized for surgical heart valve disease, with occasional pre-operative finding of ≥ 50-70% coronary artery stenosis, without angina, are examined. After interdisciplinary discussion in the Heart Team, it was decided not to treat coronary artery disease during valve surgery. The aim is to evaluate the short and medium-term results of this "conscious omission".

Inclusion Criteria:

• adult patients
• Presence of valve disease of surgical interest.
• Occasional pre-operative finding of coronary stenosis >= 50-70%.

Exclusion Criteria:

• angina

Patients with any valvulopathy requiring sugery, with also critical coronary stenosis of 50-70% or more.